Journal of Physician Assistant Education最新文献

Introduction: This study aims to determine whether veterans have differential access to physician associate/assistant (PA) education by examining likelihood of matriculation relative to nonveteran peers. We explore associations between veteran status and likelihood of matriculation for change over time and whether effects differ among active duty versus non-active-duty applicants.

Methods: Multivariate logistic regression was used to investigate associations between self-identified military status and likelihood of PA program matriculation in five Centralized Applicant Services for Physician Assistants admissions cycles (2012-2013, 2014-2015, 2016-2017, 2018-2019, 2020-2021). Models controlled for age, sex, race/ethnicity, patient care experience hours, total undergraduate grade point average, and number of applications submitted and applied a Bonferroni correction for alpha inflation.

Results: Veteran applicant numbers were small across the study time frame but increased from 2012 (n = 708) to 2020 (n = 978), representing a 38% increase over the lookback period. Despite growth, the proportion of veterans in the matriculant pool has decreased from 4.2% in 2012 to 3.0% in 2020. In unadjusted models, military status was not strongly associated with odds of matriculation. In adjusted models, both veteran and active-duty status were associated with higher odds of matriculation, although this increase was not statistically significant at the 0.005 level for applicants on active-duty.

Discussion: Military veterans and active-duty military personnel have higher likelihood of matriculation into US PA programs relative to nonveteran peers. The proportion of veterans in the matriculant pool has decreased over time. This suggests that while PA programs seems to value previous military experience, further efforts to evaluate and address barriers to military veterans in applying for admissions is needed.

Introduction: Physician assistant (PA) students will be certain to provide care to patients with disabilities in their future careers. However, there is a dearth of literature on disability-related education in PA training. This curriculum sought to fill this need. The specific aims of this study were to (1) evaluate the implementation of a 3-part disability-focused education curriculum in PA education, (2) assess changes in PA students' self-perceived confidence and attitudes toward patients with disabilities, and (3) assess students' attitudes toward ADEPT-CARE.

Methods: A 3-part disability curriculum was implemented into the first-year PA curriculum at a single Mid-Atlantic institution. Students could voluntarily complete pre and post-surveys which assessed their self-perceived confidence and attitudes toward people with disabilities, perception of the curriculum, and attitudes toward ADEPT-CARE and disability health.

Results: Thirty students participated in the study, with a 100% survey response rate. Nearly all participants agreed or strongly agreed that this curriculum enhanced their medical education (n = 28, 96.6%, frequency missing n = 1). After curriculum completion, there was a statistically significant improvement in participants' confidence in their ability to assess patients with disability (46.7%-93.3%, P < 0.001), ability to provide the same quality of care to patients with disability as those without disability (80.0%-96.7%, P = 0.025), and perception of quality of life of persons with disabilities ( P = 0.030).

Discussion: This curriculum was well received by PA students and improved their attitudes toward patients with disabilities, thereby fulfilling a critical need for PA educators.

Introduction: Both faculty and student learners associated with physician assistant/associate (PA) programs continue to suffer from the effects of the ongoing mental health crisis. Furthermore, student learners may have other personal needs impacting their potential success in PA school (ie, financial, academic, or other). A proactive approach to supporting student learners early in their PA educational journey is warranted.

Methods: Required 1:1 face-to-face orientations between incoming PA students and a representative from the Office of Wellness and Academic Support (OWAS) were implemented during the first week of PA program orientation. Students were allowed time and space to privately share their individual experiences and concerns as they entered PA school. In addition, the student services representative from OWAS was able to provide customized education on the variety of resources available for students.

Results: The student services representative from OWAS established personal relationships with each of the incoming PA students. Multiple follow-up appointments and referrals were made to various service lines including tutoring, learner accommodations, and mental health counseling.

Discussion: The implementation of required 1:1 face-to-face orientations between incoming PA students and student services during the first week of PA program orientation was highly effective. The primary lesson learned is that a simple, preventative, proactive approach can be extremely impactful if we are willing to view the challenges of student learners in PA education through a different lens.

Introduction: The objective of this study was to discuss evidence-based strategies to promote a culture of well-being with physician assistant (PA) education.

Methods: Published literature on medical student, resident, and PA student well-being was reviewed with findings subsequently categorized according to well-being strategy.

Results: Five themes were found from existing well-being research within medical student and PA student education: faculty role modeling and support, dedicated curricular time, pass/fail grading schema and de-emphasizing grades, peer support and learning communities, and evaluation importance.

Discussion: Physician assistant educators may be able to foster a culture of well-being for their students by making even small adjustments to the existing educational curriculum.

Introduction: To gain admittance to a physician assistant (PA) school, applicants must complete program-specific prerequisite courses and experiences. The lack of standardization contributes to complexity, expense, and limits diversity. This research assessed current didactic PA students' perceptions of prerequisite courses, course delivery methods, and direct patient care (DPC) experiences to determine which were perceived as the most useful in preparation for didactic PA education.

Methods: An online cross-sectional survey was sent to eligible PA students across the United States. The survey collected opinions on the usefulness of commonly required prerequisite courses, course delivery methods, and DPC experiences. Collected data underwent statistical analysis and qualitative analysis for open-response questions.

Results: A total of 527 students completed the survey. Greater than 50% reported prerequisite courses in science and psychology as well as speech, ethics, cardiopulmonary resuscitation (CPR), medical ethics, medical terminology, and nutrition "prepared them well" or "extremely well." The most frequently recommended educational delivery method was "in person." The DPC experiences reported to best prepare students were Medical Assistant, Certified Nursing Assistant, and Scribe. The reported recommended number of DPC hours was 1000 to 1499. Chi-square tests for courses that prepared students "well" and "extremely well" revealed that in-person delivery had a statistically significant association with anatomy, physiology, ethics, CPR, medical ethics, and Spanish.

Discussion: These significant findings should be considered by PA programs when evaluating their requirements for admission. Furthermore, PA education associations should consider universal requirements to reduce applicant barriers, complexity, and expense, which may lead to improved diversity.

Abstract: The 2023 US Supreme Court holding in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina, et al. has changed the landscape in higher education admissions processes by declaring affirmative action unlawful. It is imperative that those working in higher education admissions understand the ruling and implement contemporary best practices. Institutions of higher education who wish to promote student diversity are tasked with developing alternative strategies to affirmative action and must steer clear from using race as a determinant factor in admissions decisions. Aiming to identify diversity in individuals' lived experiences, focusing on recruitment efforts that organically lead to diverse applicants, adopting holistic, mission-driven admissions processes, and enhancing robust retention efforts may be effective means of fostering student diversity.

Abstract: The purpose of this descriptive research project was to examine the technical standards of physician assistant (PA) programs for mental health keywords, phrases, and themes. Each program's standards were analyzed, and keywords, phrases, and major themes were extracted and compared. The results demonstrate that most US PA programs include language related to mental health in their technical standards including theme areas of emotional health, emotional stability, mental health, emotional well-being, and stress management. No patterns between the wording of mental health content and accreditation status emerged. Given the increasing proportion of mental health diagnoses among the general population, and, by extension, applicants to PA training programs, institutions are encouraged to re-evaluate their technical standards to ensure they remain current and appropriate and contain language inclusive of mental health domains such as emotional stability, emotional health, and stress management.

Purpose: The aim of this study was to investigate the disparities in career progression and the need for inclusive mentorship in the physician assistant (PA) profession, specifically focusing on racial/ethnic minority faculty.

Methods: Pooled data from the Physician Assistant Education Association Program Survey in 2015, 2017, and 2019 were analyzed to examine the effect of PA faculty race/ethnicity on academic rank promotion. Logistic regression models were used to assess the association between faculty race/ethnicity and the likelihood of being in a middle/late-career (associate/professor) or early-career status (instructor/assistant), adjusting for confounding factors.

Results: The analysis revealed significant disparities in career progression, particularly for Black/African American and Hispanic faculty members, who were 44% less likely to be in late-career positions compared with White faculty. These disparities persisted even after accounting for gender, highest degree, region, and years in rank. The slower career progression experienced by minoritized faculty can have negative impacts, such as lower salaries, impostorism, reduced social capital, isolation, marginalization, burnout, and attrition.

Conclusion: The findings highlight the urgent need for increased efforts to promote diversity and inclusion in the PA profession. Creating a more equitable academic environment requires addressing systemic biases, implementing inclusive mentorship initiatives, and promoting diversity in hiring and promotion decisions. By prioritizing equity, diversity, and inclusion, the PA profession can foster a more diverse, innovative, and satisfied workforce while reducing turnover. Continued research and evidence-based strategies are essential to effectively address these disparities and create a more inclusive and equitable environment in the PA profession.

Introduction: Physician assistant (PA) education in the clinical year is dependent on clinical preceptors. Recruitment of preceptors has been identified as a significant barrier for programs. As a result of the preceptor shortage, evaluation of the barriers to recruitment and retention has been considered. The lack of development and training was identified as a barrier to recruitment and retention of preceptors.The aim of this scoping review article was to identify structured teaching strategies to reduce the development and training barrier and improve preceptor efficacy and efficiency. Structured teaching techniques, such as the One-Minute Preceptor and Summarize, Analyze, Narrow, Probe, Plan, and Select (SNAPPS), are proven to be effective and efficient ways to train learners.

Methods: Online databases were used to identify articles published from 2014 to 2022 using the following terms: "physician assistant" or "nurse practitioner," "preceptor development," "preceptorship," "teaching methods," "pedagogy," "clinical teaching," and "medical education." Seventeen articles formed the basis of the scoping review of the literature. A singular author reviewed the articles.

Results: Training resources help ease student instruction burden that preceptors experience. Many preceptors rely on clinical experience to guide their teaching methods. Introducing formal, structured teaching strategies can improve preceptors' effectiveness. By implementing preceptor training using structured teaching strategies, PA programs can decrease barriers for preceptors and potentially increase preceptor effectiveness and efficiency.

Conclusions: Training preceptors on using structured teaching strategies through workshops, asynchronous learning modules, and podcasts could provide preceptors with the support needed to educate clinical phase PA students. Physician assistant programs must explore best practices in clinical teaching and the associated education and operational outcomes.

Purpose: The impact of holding a doctoral credential by clinically practicing physician assistants/associates (PAs) remains unknown. The purpose of this study was to investigate practice patterns and describe demographic characteristics of PAs who have terminal doctoral degrees.

Methods: This was a secondary analysis of data obtained from the 2021 Salary Survey of the American Academy of PAs. A total of 13,865 PAs responded to the survey for an estimated response rate of 13.3%. We examined the relationships between holding a doctoral degree, demographic characteristics, and work-related variables. Descriptive bivariate statistics and chi-square tests were used for data analysis.

Results: Most of the PAs (93.6%) with doctoral degrees were older than 30 years and self-identified as female (55%). There were higher proportions of non-White individuals among those with doctorates compared with general PA population. Of the PAs holding doctoral degrees, 90.4% were primarily clinicians and 9.6% were primarily educators. Physician assistants/associates with doctoral degrees were employed with their current employer longer than PAs without doctoral degrees. Most of the PAs with doctoral degrees held informal or formal leadership and had an annual salary above the median (62.3%) compared with PAs without doctoral degrees (40.0%).

Conclusion: There are statistically significant differences in practice patterns and demographic factors between PAs with and without doctoral degrees. Physician assistants/associates with doctoral degrees were older, were male, and held leadership positions. Taken together, holding a doctoral credential may improve upward mobility at workplaces. Qualitative studies are warranted to further understand the motivation and impact of holding a doctoral credential among clinically practicing PAs.